Sagging and marionette lines in lower face. What are my options? (photos)

Thank you for your question and photos. You may benefit from dermal fillers as well as a PDO thread lift. Injectable fillers are often used to reduce the appearance of marionette lines and provide powerful, yet subtle anti-aging results.

A PDO thread lift is an excellent choice for addressing skin laxity and early jowl formation. This non-surgical option uses dissolvable sutures to lift tissue and tighten the skin to produce a natural, youthful-looking appearance. I recommend scheduling an in-person consultation with an experienced injector who can help you choose the best approach for your desired results.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Thank you for your enquiry and sharing your photographs.

I feel that your med spa advice was very sensible. Adding volume around the marionette lines unfortunately will make surgical corrections more difficult.

In terms of escalating treatment levels you could consider:

- Minimal intervention treatments like threads

- A minimal access facelift .

- A formal short scar facelift procedure is the most powerful to affect changes for the area of concern to you. It seems however a bit excessive for your age and the magnitude of the problem.